Agenda and minutes

Apologies from:

Helena Kania (LINk)

Kevin Dowd (HAVCO)

Claire Andrews (HFOP)

None received.

None received.

A brief overview of the changes to the health service structure.

Jill Shattock, Director of Clinical Commissioning, Haringey Clinical Commissioning Group (CCG)

Jill Shattock, Director of Clinical Commissioning (Designate) gave a summary of the main changes to the health structure from 1^st April 2013.

•         Primary care trusts and strategic health authorities to be abolished

•         Public health functions moving to local authorities

•         Clinical Commissioning Groups (CCGs) to take over commissioning for local areas and be statutory bodies (Haringey CCG is on track to be fully authorised from 1 April with one or two conditions).

•         Commissioning Support Units will support CCGs (in Haringey we are supported by the North and East London CSU)

•         NHS Commissioning Board will be responsible for primary care contracting and for the authorisation of CCGs

•         Ownership of buildings will move to NHS Property Services Ltd or to providers

•         Health and wellbeing boards will be established

•         LINks will be abolished and replaced by local Healthwatch.

The Panel will receive a presentation on:

·        Changes to the unscheduled care system in Haringey, including the introduction of the new NHS 111 phone number

·        Change in provider for Out of Hours services in Haringey and what this means for residents.

Attendees

• Jill Shattock, Director of Clinical Commissioning, Haringey Clinical Commissioning Group (CCG)
• Dr John Rohan, Haringey GP and Haringey CCG Governing Body member (unscheduled care lead)
• Alison Blair, Senior Responsible Officer for the NHS 111 programme
• Sarah McIlwaine, Senior Programme Manager, NHS 111 programme
• Annette Alcock, Deputy Chief Executive, Barndoc
• Dr Anuj Patel, Medical Director, Barndoc
• Christine Callender, Director of Operations and Nursing, Barndoc

The Panel heard from:

·        Jill Shattock, Director of Clinical Commissioning, Haringey Clinical Commissioning Group (CCG)

·        Dr John Rohan, Haringey GP and Haringey CCG Governing Body member (unscheduled care lead)

·        Alison Blair, Senior Responsible Officer for the NHS 111 programme

·        Sarah McIlwaine, Senior Programme Manager, NHS 111 programme

·        Annette Alcock, Deputy Chief Executive, Barndoc

·        Dr Anuj Patel, Medical Director, Barndoc

·        Christine Callender, Director of Operations and Nursing, Barndoc

The Panel received an overview of the 111 and Out of Hours service.  The following points were noted:

111

·        The basic idea of 111 is to ensure that people access the right service at the right time – “Right First Time”.

·        111 is a national service.

·        Haringey is working with the other four areas in the North Central London cluster to set up a local version with local information.

·        The service is being rolled out in April 2013.

·        It is a free to call number for when you need medical help urgently but when it isn’t an emergency.  ‘Urgent’ is defined by the called when deciding whether to call 111 or 999.

·        111 calls are answered by call handlers, all of which are supervised by clinicians.   The call handlers assess the urgency of the call and look at best possible local services and how these can be accessed.

·        It is different to NHS Direct which stops at the end of March in London.

·        The aim of 111 is to deal with callers at the time of their initial call.  You can also be referred to another provider.

·        111 can send information to other providers e.g. GP surgery.

·        111 can send you an ambulance if needed.

·        At the time of the meeting the 111 service in Haringey was being tested ready for go live.  It is not yet being advertised as services which are not live can not be advertised.

·        The content of the local Directory of Services, which 111 access when speaking to patients, is influenced locally by the Haringey CCG.

Out of Hours

·        North Central London is currently split with the North section out of hours being provided by Barndoc and the South section being provided by Harmoni.

·        In Haringey provision of out of hours by Harmoni ends on 1^st April and Barndoc takes over as of 2^nd April.

·        Harmoni will continue to provide out of hours in Camden and Islington and Barndoc will cover Barnet, Enfield and Haringey.

·        The 2012 activity statistics showed that 10,212 residents contacted out of hours services.  Of these

1.    8,366 patients had a face to face appointment at a site.

2.    The remaining received advice on the phone or where referred to other providers the next day e.g. pharmacist or GP.

3.    N.b These figures do not include home visits which are counted separately.  These will be provided for the Panel.

4.    Of the 8,366 the following shows which bases Haringey residents visited:

·        5,306 at the Laurels

·        2,527 at the Whittington

·        259 at St Pancras

·        274 at Homerton (  ...  view the full minutes text for item 50.

Dr Yi Mien Koh, Chief Executive, Whittington Health

Representatives:

• Dr Koh
• Dr Greg Battle
• Philip Yent
• Richard Martin

Dr Greg Battle introduced the item with the following points:

• The Estates Strategy is one of a number of plans and falls out of the integrated care strategy
• There is recognition that they did not consult properly with both Members and residents and that there is more work to do.
• The Strategic Health Authority has asked them to pause taking forward their Foundation Trust application by 4-6 months.  They are therefore in ‘listening mode’.
• The SHA has said they like their overall strategy and integrated care vision however:

·        They need to gain more clarity on financial savings;

·        Do better at communicating; and

·        Work harder around staff and community engagement.

The following discussion points were noted

• Listening mode is about listening to comments and concerns and about communicating.
• The Whittington recognises that they have not made the link between the clinical strategy and the estates strategy clear enough to people.
• The Whittington recognises that they have failed to get people on board and to get people to understand the clinical background
• The Estates Strategy could be modified during this pause.
• The Adults and Health Panel have recently visited St Ann’s hospital site and Chase Farm mental health wards.  At their visit to St Ann’s they were able to see the conditions of the buildings and the site overall and therefore gain a better understanding of the redevelopment issues and needs.  This same opportunity has not been presented by the Whittington.
• The Panel noted that a lot of elected Members have been informed of what is happening via the press as opposed to from the Whittington communicating directly with stakeholders, including the Adults and Health Scrutiny Panel.
• The Panel queried whether the Whittington had shared the strategy with Haringey Clinical Commissioning Board (CCG) and shadow Health and Wellbeing Board (sHWB).  They were informed that the CCG had given their general support to the clinical strategy in writing, which had enabled the Whittington to approach the SHA regarding Foundation Trust status.  However, it was not thought that this included the Estates Strategy.
• The Panel queried whether discussions had taken place with Adult Services on possible implications and were informed that this was ongoing.
• The Panel were informed that the Whittington Board is deeply committed to having an A&E on site and that they are fully committed to having a full set of clinical services around the A&E.
• Dr Koh informed that Panel that they hope to keep all clinical services which are there at the moment, however sometimes directives come from above as happened with stroke services.
• The Panel queried the percentage of the current land which was intended for sale and how much of the strategy is finance led.  The Panel were informed that the strategy is a direction of travel and that the Whittington reserves the right not to sell buildings and use them for something else if they wish.  With regards to the percentage, it is about 40%  ...  view the full minutes text for item 51.

Panel Members will consider the implications of the Francis report comments and recommendations on Health Overview and Scrutiny.

The Panel discussed ways in which they could ensure that all information is captured to enable them to have a better overview of any possible issues, for example by using Councillors casework and ensuring a strong relationship with HealthWatch.

The Panel agreed to revisit the scrutiny recommendations following the government response and at the start of the new municipal year in order to build improvements into the work of the Panel.

To approve the minutes of the meeting held on 10^th January 2013.

Agreed

None received

Tuesday 2^nd April 2013, CR1, Haringey Civic Centre

2^nd April, 6.30pm